Tarek Nabil Metwally

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2901022583 Issued in MI

Practice address

22180 Pontiac TRL Ste a
South Lyon, MI 48178-9097

Phone

(248) 486-9202

NPI assigned

Jun 8, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Maxillofacial SurgeryAlso: General Surgery, Oral Surgery

Education

University of Michigan School of Dentistry, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oakland Oral Surgery AssociatesGroup PAC ID 9436196235, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Oakland Oral Surgery Associates

  • Oral and Maxillofacial Surgery (Dentist)
  • Sterling Heights, MI
  • NPI 1033299052
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1669965257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42051 MOUND RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483143143",
            "telephone_number": "586-323-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22180 PONTIAC TRL STE A",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481789097",
            "telephone_number": "248-486-9202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Michigan Medicine, University of Michigan Dept of OMFS",
            "address_2": "1515 Hospital Dr. G1218 Towsley, SPC 5222",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481095222",
            "country_code": "US",
            "telephone_number": "734-232-4765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "METWALLY",
        "first_name": "TAREK",
        "middle_name": "NABIL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-08",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901022583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer McPherson, RD
• Meghan N Moore DDS PLLC
• Elena Marie Mehl, M.D.
• Gabrielle M Mercieca, DDS
• Morgan J Merrill-Winowiecki, NP
• Michelle R Conforti
• Michigan Rehabilitation Specialists of South Lyon LLC
• Michigan Rehabilitation Specialists South Lyon, Inc.
• Jaclyn Esther Michniak
• Midwest Spine and Sports Center PLLC

• Oral and Maxillofacial Surgery (Dentist) in South Lyon, MI
• Providers in South Lyon, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.